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Case Reports
. 2021 Jun 8;13(6):e15515.
doi: 10.7759/cureus.15515. eCollection 2021 Jun.

Flushing: A Diagnostic Dilemma

Rekha Ravikumar  1 , Salil Avasthi  1   2 , Deepti Avasthi  1
Affiliations
Case Reports

Flushing: A Diagnostic Dilemma

Rekha Ravikumar et al. Cureus. .

Abstract

Carcinoid tumors are uncommon tumors that are often diagnosed in later stages of the disease due to their indolent nature, vague clinical presentation and overlap of symptoms with other conditions. We report a case of rectosigmoid carcinoid tumor which was found incidentally on screening colonoscopy in an elderly woman that went undiagnosed for several years due to confounding effects of symptoms of post-hysterectomy menopause with that of carcinoid syndrome. Persistent episodic flushing with or without diarrhea not resolved with standard treatment should lead to suspicion of neuroendocrine tumors (NETs). This case report emphasizes the need to broaden our perspective of menopausal symptoms and pay attention to the characteristic clinical symptoms of NETs.

Keywords: carcinoid syndrome; delayed diagnosis; flushing; hot flashes; menopause; neuroendocrine tumor.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. (a) and (b) are rectum. (c) polypoid mass in rectum. (d) sigmoid colon
Figure 2
Figure 2. Normal mucosal glands are present on the right and bottom of the slide with nests of well differentiated neuroendocrine tumor (carcinoid tumor, small blue cell groups) in the submucosa and superficial muscularis propria in the left and upper portion of the slide. (Hematoxylin and Eosin, 100X)
Figure 3
Figure 3. Corresponding synaptophysin immunostain demonstrates brown staining in isolated normal neuroendocrine cells in mucosal crypts in the right and bottom of the slide and highlights tumor nests in the submucosa and muscularis propria in the left and upper portion of the slide. (100X)
See this image and copyright information in PMC

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